Recent advances in digital saliva biosensors for point-of-care testing and periodontitis monitoring: A Narrative Review

Background: Periodontitis is a chronic inflammatory disease of periodontal tissues with an age-standardized prevalence rate (ASPR) of 12,498.3 per 100,000 population (GBD 2021), and 74.1% of Indonesians suffer from periodontal problems (Riskesdas 2018). Conventional diagnostic methods are invasive, subjective, and tend to detect disease at an advanced stage. Saliva has the potential as a non-invasive diagnostic alternative through portable biosensors and digital integration. 

Objective: This review aims to analyze the potential integration of saliva-based biosensors with digital systems in enhancing the effectiveness of diagnosis and monitoring of periodontitis. 

Methods: A literature search was conducted on PubMed, ScienceDirect, Research Gate and Google Scholar using predetermined keywords and the results were limited to articles published in 2020-2025

Discussion: Biosensors are used as Point-of-Care Testing (POCT) by detecting saliva inflammatory biomarkers, then integrated with digital technology for biomonitoring, such as smartphones, artificial intelligence, or Internet of Things (IoT) in the form of mouth guards and intraoral patches. Surface Plasmon Resonance-based Plasmonic Fiber-Optic Biosensors work by utilizing specific antigen-antibody bonds detected by spectrophotometry, while Electrochemical Impedance Spectroscopy (EIS) works by measuring changes in resistance or impedance at the electrode. Molecularly Imprinted Polymer (MIP) detects biomarkers by electric current changes and then converts them into concentrations. Biomarker signals detected by biosensors are transmitted wirelessly to external devices, where noise is filtered using deep learning, thereby improving accuracy and also enabling real-time personalized monitoring.

Conclusion: Saliva biosensors as POCT and digital biomonitoring offer earlier, minimally invasive, rapid, and personalized disease detection.